Transcript: Is Fish Oil Just Snake Oil?

Are purported benefits of fish oil supplementation for the prevention and treatment of heart disease just a fish tale? Thanks to recommendations like this from the American Heart Association, that individuals at high risk for heart disease ask their physicians about fish oil supplementation, it’s grown into a multibillion dollar industry. We now consume over 100,000 tons of fish oil every year.

But what does the latest science say? A systematic review and meta-analysis published in the Journal of the American Medical Association looked at all the best randomized clinical trials evaluating the effects of omega-3’s on lifespan, cardiac death, sudden death, heart attack, and stroke. Either advice to eat more oily fish or to take fish oil capsules. What did they find? Overall, they found no protective benefit for overall mortality, heart disease mortality, sudden cardiac death, heart attack, or stroke.

What about for those who already had a heart attack and are trying to prevent another? Still no benefit. Where did we even get this idea that omega-3’s were good for the heart? Well if you look at some of the older studies, the results looked promising, for example the famous DART trial back in the 80’s involving 2,000 men. Those advised to eat fatty fish had a 29% reduction in mortality. Pretty impressive; no wonder it got a lot of attention, but people seemed to have forgotten about the sequel, the DART-2 trial. Same group of researchers, an even bigger study--3,000 men, and those advised to eat oily fish and particularly those supplied with fish oil capsules, had a higher risk of cardiac death.

Put all the studies together, and there’s no justification for the use of omega-3’s as a structured intervention in everyday clinical practice or for guidelines supporting more dietary omega-3s. So what should doctors say when their patients follow the American Heart Association advice to ask them about fish oil supplements? Given the new meta-analysis and other negative meta-analyses, our job as doctors should be to stop highly marketed fish oil supplementation in all of our patients.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Ariel Levitsky.

But if the benefits aren't there, then all one is left with are concerns over the industrial pollutants that concentrate in the fish fat (even in distilled fish oil, see Is Distilled Fish Oil Toxin-Free?).

These same contaminants are found in the fish themselves. This raises concern for adults (Fish Fog), children (Nerves of Mercury), and pregnant moms:

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One’s dietary omega three/six ratio is an independent risk factor for disease. (http://www.ncbi.nlm.nih.gov/pubmed/18408140) Did these studies account for the RATIO of omega fatty acids?
The typical westerner has a dietary omega fatty ratio of 15/1. It’s pretty reasonable that simple supplementation wouldn’t do much.

guest

How about the vegan DHA omega 3 oil supplements? Have there been similar studies done on these, and are there any long-term studies or science available that has measured the risk of long-term vegan DHA supplementation? Or are we just assuming these are safe to take (based on our best assessment of the available yet limited science), while knowing that the fish oils are not?

Veganrunner

Good questions. I am thinking this may shake out to what we already know. Supplementation is never as good as the whole food. (Exception B12) Flax seed etc. I know mine have been sitting in the fridge untouched.

What have you found Dr Greger? Are we wasting our money?

brec

And indeed what about flax seed used as a supplement? As a CHD patient following Esselstyn’s dietary regimen I’ve also been following his recommendation of a tablespoon a day of flaxseed meal specifically for Omega-3 fatty acids.

Yes, it’s whole food and I’ve been adding ground flax seeds to my oatmeal. But in other contexts Esselstyn recommends avoidance of high-fat foods such as nuts, avocados, tahini, etc. for us who have CHD.

DGH

Flaxseed does not convert to DHA. (If that’s important to you).

Israel Navas Duran

That’s an oversimplification. Women can transform a significant percentage of EPA into DHA:

“The fractional conversion of ALA to EPA, estimated by measuring peak or area under the curve plasma contents of the labeled fatty acids, varies between 0.3% and 8% in men, and the conversion of ALA to DHA is ≤4% and often undetectable in males (39, 40, 44, 45). Conversion of ALA to long-chain n—3 fatty acids appears to be more efficient in women: up to 21% is converted to EPA and up to 9% is converted to DHA (38), with a concomitant reduction in the rate of ALA oxidation (

e

I assume women create more due to estrogen, so possibly the DHA created is for fetal brain development, and not so important in adults, otherwise men would create as much ??

Carol

Yes, DHA is crucial to the developing brain. Human breast milk is the richest source of DHA on earth. Clearly humans need this! MIDAS and other studies point out its importance to adults as well. Since Israel, DGH and others have pointed out that ALA doesn’t convert very well to DHA, particularly in the presence of LA, it is best to go straight to a fish, or, perhaps even better, an algae source of DHA.

Shaylen Snarski

Yes, your body does convert the ALA found in flax, to DHA and EPA, so saying that it doesn’t is absolutely untrue. It’s not known how well, but they certainly do in some amounts. Hemp contains SDA which helps further this process. But you can get pure plant DHA from algae, which is how fish get it in the first place. I make it a point to recommend omegaZen pure DHA, not because I’m affiliated with this or any company, but because I am against the use of palm oil as it is one of the most devastating epidemics on our planet right now (and so unhealthy too!) and it is virtually added to all other concentrated algae supplements. Also I like the purity of this product which is an absolute must for me.

Kim Churchman

Thank you!

Kim Churchman

Really? How is that?

Roberta Peck

Yes ,besides suggesting flax, Esselstyn, and McDougle promote no oils ,avocados,or nuts. Whereas Dr Greger and Dr Furhman both point out that about an ounce of nuts daily has proven heart healthy. Nutricianist Jeff Novak, who is a friend of all these doctors, actually recommended a patient who was not doing well under Esselstyn to Dr Joel Furhman author of the book Eat To Live, and this heart patient recovered amazingly well.

Shaylen Snarski

Those foods contain healthy fats and extreme health benefits. You should not avoid these foods. But do avoid extracted oils from these foods and other extracted oils such as cottonseed oil, safflower/sunflower oil, soy oil, corn oil, etc. All excellent foods (except cotton of course lol), but in their whole form.

Roberta Peck

Flax seed oil is notorious for going rancid quickly, fleshly ground flax seeds, as a whole food,offer other benifits as well, like lignans

Kim Churchman

Flax seeds are hard to chew thoroughly enough to get benefit. There’s nothing wrong with my teeth (I’m a dental hygienist and my dental exams are fine) but when I chewed a teaspoonful and carefully spit them onto a paper towel, I was disappointed to see uncrushed seeds. I buy a flax oil brand, Barlean’s, with the label describing the manufacture being done under a ‘nitrogen blanket’. Nitrogen, a gas, is heavier than air and displaces oxygen, preventing rancidity.

Daniel

@Kim Churchman — Grind your flax seeds in a propeller coffee grinder. To remove the coffee or other flavors in the grinder, grind a handful of rice first.

I simply stir the ground flax seeds into a small glass of water and toss it back.

Carol

The flat blade of the Magic Bullet/ Nutribullet grinds seeds well. A simple mortar & pestle also works, for less money! Of course you can buy pre-ground (kept in fridge), but it’s not quite as fresh & tasty.

Thanks, but “…or so I’ve heard. I guess…” doesn’t work for me. For dietary vegans who want to consume EPA/DHA supplements directly — i.e., in capsules, as opposed to ALA — there are algae-based sources available. Indeed, that’s where the fish get their Omega-3s.

Lori

Mercola is a notorious charlatan. I wouldn’t believe anything from his site.

Toxins

I agree, Mercola runs a for profit nutrition business. That alone results in a loss of credibility.

Carol

Respectfully disagree. A thoughtful reader can glean information from Dr. Mercola’s many free articles (which always include a list of references, including applicable published research on PubMed) and the reader can decide for himself whether or not to buy anything (I never have). Likewise, the fact that Dr Greger advertises his book on this website doesn’t diminish his credibility in the least.

Thea

Carol: The difference is that Dr. Mercola is personally making money off of his website. Dr. Greger makes no money off this website, his book, nor his speaking engagement. *All* proceeds are donated directly into running this website as a service to the public. There is zero conflict of interest in the information on this site. Now, that doesn’t necessarily mean that Dr. Mercola’s information is wrong (though from what I’ve seen, it often is), but it is an important difference that should not be lost.

Carol

How can we say that Mercola doesn’t also use proceeds to maintain his free website? Let the reader decide if the references he gives at the end of his articles (including research on PubMed) are adequate enough to back up his points. He does claim to donate some proceeds to the American Botanical Council, Organic and Natural Health Association, Caminos de Agua, Organic Consumer Association, Food Democracy Now and other charitable organizations as well.

Thea

Carol: re: “How can we say…?” Because as you say yourself, Dr. Mercola says himself that he only donates *some* proceeds. Dr. Greger donates *all* proceeds.
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re: “Let the reader decide if the references he gives at the end of his
articles (including research on PubMed) are adequate enough to back up
his points.” Of course. But the conflict of interest (plus the known problems of Mercola’s positions) must be noted. As we have seen explained on this site and demonstrated in practice in many places such as paleo sites, it is very easy to provide references (including research on PubMed) and sound convincing. But those references can be totally misleading about what the evidence in the study is saying, or have invalid data and processes or be non-representative of the body of evidence. Most people do not have the skills and knowledge base to evaluate references and the credibility of scientific-sounding articles. That’s the key point. And for proof, just look at how many people have fallen for the Weston Price Foundation or the Eat For Your Blood Type diet. So, sometimes pointing out conflicts of interest, such as was done for Dr. Mercola, is all we can do to help some people judge the quality of someone else’s information.
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Here’s another thought for you: From my experience, nobody is wrong about everything and nobody is right about everything. If you have found some information on Dr. Mercola’s site to be right in your opinion, that’s great and I’m happy for you. But that doesn’t take away the validity of pointing out Dr. Mercola’s major conflict of interest, creating a potential for bias that the common lay person must keep in mind.

Carol

You make such an excellent point that no one is entirely wrong or entirely right!! We can’t be overly biased and throw babies out with the bathwater. That’s why it’s sad to hear you agree with a statement calling another doctor a “charlatan” (sounds biased). No matter how many times you restate it, I do not agree about the conflict of interest. If Dr. M recommends vitamin D, I can (1) print out the research he cites and take it to my doctor (which anyone can do w/ the research Dr. G cites, too). Dr. G recommends vitamin B12, a very crucial micronutrient not found in the plant kingdom. (2) I can buy ANY BRAND of vitamin D or B12 out there (I don’t buy Mercola’s supplements! I compare
various brands on Consumer Lab’s site). If a broccoli farmer says that such-and-such a study shows broccoli is a
potent cancer-fighter, that’s great info- a springboard for further research- and ultimately I can buy my broccoli from any supplier I choose! . . . This whole argument is largely unnecessary, because first of all, Mercola advocates common sense measures such as a plant-strong diet, exercise, moderate sunshine and fresh air as first line of care, above supplements. It is true that, Like Dr. Furhman, he doesn’t completely omit animal products, but he very clearly states that dairy isn’t for everyone!! Second of all, our entire medical establishment is
for profit, and conflicts of interest abound. Does that mean they are all charlatans with nothing to offer? Like all other doctors, mainstream or otherwise, both Dr. Greger and Dr. Mercola must earn a living, and I
do not begrudge either of them that. Both of them run free websites that
must be financed one way or another, whether it’s with books or
supplements. It makes no difference to me that Dr. M sells his own supplements; his free articles are extremely informative and offer a springboard for me to do further research on my own and make decisions together with my doctor.

Thea

Carol: You replied to Rami. I was agreeing only with Rami’s statement which was, “…Mercola runs a for profit nutrition business. That alone results in a loss of credibility.” I was not responding to the claim of Dr. Mercola being a charlatan or not. Saying that credibility is hurt is not the same as saying that someone is 100% wrong about everything or that the person is trying to cheat people.
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re: “…our entire medical establishment is for profit, and conflicts of interest abound. Does that mean they are all charlatans with nothing to offer?” No, they are not all charlatans. As I said, this discussion is not about being a charlatan per say, but about the conflict of interest.
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But “Yes!” we should be *very* careful when we interact with the medical community. Our very lives could be at stake. So, we should be aware of which potential conflicts of interest exist. For example, if we interact with say a surgeon, we need to be aware that the surgeon likely has a bias toward surgery, whether surgery that is the best option for us or not. (Though there was an awesome surgeon commenting on this site recently who counsels patients to give up dairy so that the patients won’t need ear surgery. Of course, not all patients listen. And this surgeon is the exception, not the rule. I just wanted to give a shout-out to this awesome doctor who puts patients above profits.)
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We need to be especially on our toes when interacting with people who sell drugs. Drug/supplement companies are notorious for giving out false information, information that always sounds very scientific, and often enough includes references. Do these companies all give out bad information? No. But common sense says to be wary. I think Rami’s position is a good one for the general public. It would be wise for the general person to be aware that bias might be involved if they get information about a supplement from a company that sells supplements. If a doctor wants to make money off of selling supplements, that doctor’s information about nutrition and supplements needs to be taken with a grain of salt. There is definitely a loss of credibility.
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re: “…both Dr. Greger and Dr. Mercola must earn a living…” Again, conflating the two is one of the problems with your arguments. Dr. Mercola makes money selling people supplements while writing articles about those supplements, and making those articles appear to the average person to be unbiased. Dr. Greger, on the other hand, makes money with a salaried job that has nothing to do with selling anyone anything. All time spent on this website is volunteer/donated time done out of Dr. Greger’s interest in helping people and sharing medical information with the world. *All* money made off of this website, book, and speaking engagements is given to charity. Of course, like everyone, Dr. Greger is not right all the time. But Dr. Greger’s information is likely to be a lot less biased that someone who makes a living selling that information and the products it promotes.
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re: “It makes no difference to me…” You sound like you really trust and appreciate Dr. Mercola’s information. That’s totally your choice. I’m just saying that Rami’s statement is a good one for most people to keep in mind when they are thinking about Dr. Mercola’s information. I’m glad you feel that you have gotten good value from Dr. Mercola’s site. From the bottom of my heart, I wish you all the best.

Carol

Thanks! I did not intend for this to be so drawn out! :) I have NO relationship with Dr M whatsoever, but just had a visceral reaction to his categorical condemnation on this site. The fact that even a moderator (not you) joined in leaves this website vulnerable to scrutiny w/ regard to its objectivity.
I don’t agree with every last thing Mercola says, but his free website contains a lot of info that resonates deeply with my experience, and that of many loved ones who have been failed by our medical system, which myopically focuses on superficial suppression of disease symptoms at the expense of root cause resolution. Our medical system seems to merely “oversee the progression” of chronic diseases rather than truly reverse them. Anyway, much of Mercola’s content dovetails well with what I hear from a growing number of physicians who are connecting the dots on seemingly unrelated symptoms to understand the root causes and “common denominators” of chronic disease. I feel Dr. M’s references are usually solid DESPITE the fact that he sells supplements. If in doubt, I can research NIH’s PubMed on the topics he raises on his free website.

I believe Mercola and Greger have much more in common than that which they disagree on. They may be actually batting for the same team (lifestyle medicine), though they disagree about some of the details. I think a lot of the “food fights” going on sadly represent a house divided against itself. Hopefully this change. Thanks for your contributions to this discussion. Peace to you!

deepcleavage

A major problem with Dr. Mercola is that he refuses to cite studies that contradict his opinions. So, you get a very one-sided point of view and this can be dangerous to your health. His warnings to avoid legumes and whole grains are an example of this, as is his ignoring of numerous studies that prove that there is no link between autism and vaccines.

Rami Najjar – NF Moderator

Dr. Greger’s proceeds go towards charity, not his own pocket. Also Dr. Mercola’s citations do not back up his patently false claims. He is very good at misconstruing evidence.

Carol

Thank you for bringing up these issues. I’m not sure which sources Mercola used, but I do know that the 2015 USDA dietary guidelines state that “cholesterol is no longer a nutrient of concern” (health.gov). This is quite significant, given the very long-held belief that our blood cholesterol is significantly raised by eating foods containing cholesterol (eating cholesterol decreases our own liver’s production of it). Cholesterol is a building block for our sex hormones, cell membranes, & synthesis of vitamin D; a quarter of our brain is made up of cholesterol. Harvard Chan School of Pub. Health states that cholesterol-rich eggs can be part of a healthy diet (http://www.hsph.harvard.edu/nutritionsource/eggs/). Eggs are also rich in choline, precursor to our “learning hormone” acetylcholine, and important for liver function. Dietary fat is also being seen in a new light. Harvard Chan co-authored a study (“Worldwide trends in diabetes since 1980”, published in The Lancet), that found low incidence of diabetes in northwestern European countries such as the Switzerland, Netherlands, Austria and Belgium, where high-fat dairy is consumed in abundance (fat-free yogurt is mostly an American phenomenon!). This dovetails w/ an American Heart Association study out March 2016 (in their journal “Circulation”) linking high-fat dairy w/ lower incidence of diabetes. Of course we do not even need dairy (it causes problems for many people) and most plant-based fats are excellent. Avocados and olives are superfoods in their own right. Algae is the best source of brain-crucial DHA (recommended by Dr. Ornish, and found to improve memory in the MIDAS study). Coconut oil is rich in MCT’s (medium-chain triglycerides); if you search “medium chain triglycerides” on PubMed Central (a free archive of biomedical journal literature at NIH’s
National Library of Medicine) you will get nearly 9,000 results. This research indicates that MCT’s can help with brain and nerve function, enhance weight loss, lower inflammation, and improve gut & liver function. Two of these MCT’s are lauric acid (an antifungal & antimicrobial) and caprylic acid (excellent brain fuel). Caprylic acid is abundant in goat dairy, but coconut oil has just as much. (Btw palm oil & palm kernel oil are both from the oil palm, not the coconut palm.) Regarding fats in general, Dr David Katz recently remarked on their value in satiety (keeping
us full) and weight control. Fat also helps with blood sugar control. A greater fat-to-carb ratio helped me finally resolve YEARS of daily blood sugar roller coasters!! Lastly, It is important to note that our body cannot use the important fat-soluble vitamins, A, D, E and K, without some dietary fat to help make them bio-available.

Rami Najjar – NF Moderator

Hello Carol,

You have cited common nutrition misconceptions. Rather then write a long winded reply to you, it will be easier for you to view the following videos and articles that address your statements.

Rami- Every link you gave is circular-just leads back to this very website. It would be great if you could point me directly to biomedical research published on PubMed, the portal for NIH’s National Library of Medicine. Anyone can search PubMed for “MCT” for example, and see all published research.

Rami Najjar – NF Moderator

Carol, the videos highlight a series of studies which are available in the sources cited section of each video. These videos address the statements you are making. The studies are visually displayed in each video. I gave you the videos so you could watch them and then click the sources cited section to see further details at your leisure. It makes little sense for me to copy the links from these very videos and put them up here. The purpose of this website is to share studies through the form of easy to understand videos.

Thea

Carol: In addition to the great information you got from Rami, I thought I would point out a falsehood in your post. The USDA initially posted a draft thinking that they would remove cholesterol as a nutrient of concern. But that action would not reflect the science and that is not what actually happened. Here’s the full scoop:
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Take a look at this article which explains how the FDA got to their initial conclusion (which later got reversed): http://blogs.bmj.com/bmj/2015/04/28/neal-d-barnard-and-angela-eakin-yes-cholesterol-matters/. Very important details. As they say, the devil is in the details.
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And, as it turns out, when it came to the final/actual guidelines that got released (as opposed to the preliminary floater ideas), the FDA did the very opposite of removing cholesterol limits form its dietary guidelines. The FDA got forced to actually acknowledge the science. In the end, the FDA strengthened their warning about cholesterol. You can read about it here: http://www.pcrm.org/USDA And here is a quote:
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The Guidelines state: “As recommended by the IOM, individuals should eat as little dietary cholesterol as possible … Strong evidence from mostly prospective cohort studies but also randomized controlled trials has shown that eating patterns that include lower intake of dietary cholesterol are associated with reduced risk of CVD, and moderate evidence indicates that these eating patterns are associated with reduced risk of obesity. … Dietary cholesterol is found only in animal foods such as egg yolk, dairy products, shellfish, meats, and poultry.”
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Sometimes the truth really does win. The problem is that many websites and the media didn’t bother to report what actually happened in the end. If I were you, I’d be darn mad that the sources I rely on for good information did not inform me of this situation. Perhaps it is time to get some reliable sources of information!

Carol

The 2015 Guidelines’ original language, which came out in December, was trumpeted far and wide by all media outlets, academic institutions etc., because it was such a stunning reversal for the FDA. It stated that “cholesterol is no longer a nutrient of concern (for consumption)”. You are totally right that the wording was changed: Health.gov now says “The Key Recommendation from the 2010 Dietary Guidelines to limit consumption of dietary cholesterol to 300 mg per day is not included in the 2015 edition, but this change does not suggest that dietary cholesterol is no longer important to consider when building healthy eating patterns”(the quote you gave follows here).
Although some qualifying language was added, the strict 300mg limit was not reinstated, and for such an long-held teaching to be changed is significant.

Thea

Yes, it is very interesting that no one bothered to report that the initial draft language had to change in the final version – otherwise the FDA was going have to face the suit (and all the bad publicity that goes with it) filed by PCRM (the Physician’s Committee for Responsible Medicine). In the end, the science gave the FDA no choice. However, the public really doesn’t want to hear this bad news about their bad habits, Hence, the media and cholesterol denying blogs have kept quiet about the content of the real guidelines released months ago–causing lots of people like yourself to believe that the guidelines about cholesterol actually went away as opposed to strengthened. (The wording of the language I quoted is more important than the 300mg number you focused on.)

For anyone who did not click the first link in my original post to Carol, here is the background story on how the Committee came up with their original draft “reversal” based on the Committee’s own report:

“So how did the Dietary Guidelines Advisory Committee arrive at its not-guilty verdict? The committee wrote that its finding of no relationship between dietary cholesterol and serum cholesterol was “consistent with the conclusions of the AHA/ACC report,” citing a 2014 report by the American Heart Association and American College of Cardiology.

However, the AHA/ACC report did not actually reach this conclusion. It summarized evidence published after 1998—that is, after the most recent meta-analyses were published—and called for more research, but did not suggest that there was no relationship between dietary cholesterol and serum cholesterol. Of course, the issue may be largely theoretical, because most cholesterol-containing foods also contain saturated fat—and both raise LDL cholesterol concentrations.

In dismissing the risks of dietary cholesterol, the committee may have inadvertently further confused an already bewildered public, many of whom do not differentiate dietary cholesterol from blood cholesterol, or cholesterol from saturated fat.”

And now the media and cholesterol deniers have played their parts in further confusing the public by failing to report the entire story.

So, how did the Committee come to make such a fraudulent initial recommendation? You can get some of the story from the other link in my original post which covers the money trail, at least as much of it as we know so far: http://www.pcrm.org/USDA

Carol

Wow, such drama! I can see more than one side to this coin.

Carol

The 2015 Guidelines’ original language, which came out in December, was trumpeted far and wide by all media outlets, academic institutions etc., because it was such a stunning reversal for the FDA. It stated that “cholesterol is no longer a nutrient of concern (for consumption)”. You are totally right that the wording was changed: Health.gov now says “The Key Recommendation from the 2010 Dietary Guidelines to limit consumption of dietary cholesterol to 300 mg per day is not included in the 2015 edition, but this change does not suggest that dietary cholesterol is no longer important to consider when building healthy eating patterns”(the quote you gave follows here).
Although some qualifying language was added, the strict 300mg limit was not reinstated, and for such an long-held teaching to be changed is significant.

deepcleavage

The truth does win, and it appears not to be on your side. A study that was published today found that people over the age of 60 with high levels of LDL-C “were as likely to live as long, or often longer than their peers with low levels of this type of cholesterol.” In addition, the recent failure in clinical trial of a non-statin drug to lower rates of heart attack and cardiovascular disease demonstrates that high cholesterol levels do not cause these. The non-statin drug was very effective in lowering cholesterol, but had no effect on heart attacks or mortality.http://medicalxpress.com/news/2016-06-consumption-omega-3s-linked-fatal-heart.html

Thea

deepcleavage: I have not seen the studies you are talking about. However, it does not surprise me that statins were not effective. I’ve already known this. It has to do with how the drugs work. However, a failure in statins does nothing to overturn our understanding of safe cholesterol levels and how to safely achieve those levels.
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If you would like to learn more about the science behind cholesterol levels, you are in the right place! To start, you can do a search at the top of the page.

deepcleavage

Thea- the evidence is accumulating that cholesterol does not cause heart attacks or heart disease. I provided a link to a new study showing that this has been found to be true in individuals over the age of 60 with high LDL cholesterol.

A drug in clinical trial recently failed, because though it lowered “bad” cholesterol and increased HDL cholesterol, it did not lower heart attacks or stroke. Think about that. If statins work, they work by reducing inflammation, not cholesterol. The hypothesis that high cholesterol causes heart disease, heart attacks and stroke has been pretty much exploded. Look at this link and what the science is now saying.

Thea- you obviously don’t have a respect for science and are frighteningly rigid in your thinking. I refer to science, not “stories.” The fact that heart disease may be low in certain cultures where cholesterol levels are also low, does not prove that low cholesterol is the cause. There may be other factors such as low sugar consumption, a key source of inflammation, which is responsible for the low level of heart disease. It’s very likely, since the failure of the Eli Lily clinical trial of a drug that lowered cholesterol, but had no effect on heart attacks or stroke, offers striking evidence that low cholesterol does not prevent heart attacks.

Thea

deepcleavage: I’m not referring to stories either. I’m referring to studies which fully cover these subjects and which you can find on this site. I would give you actual links if I thought you would actually look. You did not seem to have looked at the study critiques I referred you to above…
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I can understand why you find the Eli Lily study so compelling. It seems so logical to make the conclusions you are making given how you understand that study. I’ll share two reasons why I do not find that study compelling. I haven’t read the raw study itself. So, I’ll ask you: Did the drugs in the Eli Lily study lower people’s total cholesterol levels to 150 or lower and LDL to 70 or lower? If not, then the study did not actually lower cholesterol enough. We would not expect the drugs/study to prevent heart disease if cholesterol levels were not taken to the safe levels. In other words, the study would tell us nothing about the relationship between cholesterol levels and heart disease.
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Here’s another explanation for the Eli Lily results as you report them. Artificially lowering cholesterol may just affect the indicator (the cholesterol), but tell us nothing about the relationship between the indicator (cholesterol) and the disease (heart disease). I can explain how this works by using osteoporosis drugs as an example. Osteoporosis drugs increase bone density, but studies show that the drugs do little to nothing to prevent bone fractures. Why wouldn’t increased bone density help with the osteoporosis/fracture problem? Isn’t low bone density the definition of osteoporosis? Why wouldn’t increasing bone density prevent bone factures? The answer has to do with *how* the drugs increase bone density. Dr. Klaper has a lecture which explains this mechanism better than I can. The point is: affecting the indicator (bone density) may tell us nothing about how bone density affects bone fractures. ***At the same time, no one would say that truly low bone density is not a risk factor for broken bones.*** A study showing the failure of one of those drugs to prevent bone fractures does nothing to break the link between natural (no drugs) bone density and bone fracture risk.
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There is some reason to believe that the same situation may be at work with the statin type of cholesterol lowering drugs. Just because an artificial method of lowering cholesterol (lowering to known safe levels?) fails to affect heart attacks and strokes does not necessarily tell us that cholesterol has nothing to do with heart attacks and strokes. With that in mind, put the Eli Lily study up against the body of scientific evidence regarding serum cholesterol levels and various diseases. That leaves us with no reason believe that the Eli Lily study is a game changer.
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You wrote, “The fact that heart disease may be low in certain cultures where cholesterol levels are also low, does not prove that low cholesterol is the cause. There may be other factors…” This would be a logical argument to make in the absence of that big body of evidence I keep bringing up. For example, the *only* diet shown to *reverse* heart disease is a low fat whole plant food based diet. The ability to reverse heart disease and prevent heart attacks in even the sickest of the patients has been replicated in several published studies. To my knowledge, no paleo style diet (a diet which typically raises cholesterol levels above the safe limits even though the diet is supposed to be low in those other factors you mention such as sugar) has been shown in published studies to reverse heart disease. Once you take the body of evidence into account, you can use those population studies as helpful corroborating evidence – or as examples like I tried to use for you.
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I’ll give you this, though, there are some credible experts who believe that you can have cholesterol levels above 150/70 and still not get a heart attack as long as the person eats a low fat diet of whole plant foods. With such a diet, the theory goes that the cholesterol will not oxidize and thus will not give person heart attacks and strokes. But I don’t know if we have any evidence beyond anecdotes to back that theory up. Even if it is true, it does not mean that high serum cholesterol levels are not a cause of heart disease. It just means that people may have a way to mitigate a serious risk factor. What we do know is that cholesterol levels below 150, with LDL below 70, are safe levels for almost everyone. (Look for the studies referenced on this site.)
.
Did you look at any of the videos I referred you to? Those videos will explain how easy it is to produce and publish *invalid* studies showing that eating cholesterol and cholesterol levels do not matter. They are real eye openers. Good luck.

deepcleavage

Thea- An analysis of studies with 68,000 participants over the age of 60 in the British Medical Journal, reported June 27, 2016 found that there was no association, and even an inverse relationship between LDL-C and cardiovascular death among these individuals. It was found that people with the highest LDL-C in this age group lived the longest. This study contradicted the “cholesterol hypothesis.” It was also asserted that higher cholesterol levels in this age group were protective of neurodegenerative diseases like Alzheimer’s and Parkinson’s and possibly of cancer and infections. The study leaders concluded that there was no reason to lower cholesterol levels and that it might even be dangerous to do so. Of course, you can always rationalize away these results and the failure of the Eli Lily study, but I believe that cholesterol researchers are abandoning the cholesterol hypothesis. By the way, I am not a meat eater. I eat a heavily plant based diet plus omega-3 fish like salmon and sardines. As a thoughtful person, I am beginning to question the supposed cause and effect relationship between cholesterol and CVD.

Thea

deepcleavage: I will take you at your word that you are a thoughtful person. Thus, I would expect you would listen to basic, uncontested scientific information rather than dismiss it as rationalization. So, here goes: That study you are referring to likely uses a well known phenomenon called reverse causation (among the other tricks I referred you to above). In the case of reverse causation, you can find several studies showing that older people who have lower cholesterol do not live as long. It turns out, low cholesterol does *not* cause sickness. Instead, sickness can cause low cholesterol. Thus, voila, studies showing that people who have low cholesterol do not live as long (because they were sick, not because of the cholesterol). This is the classic example of association does not equal causation.
.
On the other hand, when you look at studies that follow people who all start out healthy at a younger age and monitor their cholesterol levels going forward, you see that those people who consistently maintain the lower levels of cholesterol over time have the lowest amount of heart disease and also the lowest all cause mortality (they live the longest).
.
It does not seem thoughtful to me to ignore the mountain of evidence I have given you. You do not appear to have investigated any of it. If you consider yourself open to learning the truth, then watch the videos on the PlantPostive.com site. You will understand much better how cholesterol confusionists work and learn how to understand the science.
.
Thank you for clarifying your diet. If you had only said you were not a meat eater, I would have assumed you do not eat fish since fish is a type of meat. This site has a lot of information about the health hazards of meat, especially fish. Remember, food is a package deal. You don’t just get the omega 3s when you eat your salmon. You get the saturated fat, animal protein, cholesterol, contaminants, etc. Meanwhile you miss out on important substances like fiber and phytonutrients. Following is a nice overview of the topics concerning fish/salmon/sardines. You can then click through the links to learn more: http://nutritionfacts.org/topics/fish That’s only a start. For example, you might also want to look into the problems with animal protein and the relationship to cancer through it’s effects on IGF-1.

deepcleavage

thea: “That study you are referring to LIKELY (my caps) uses a well known phenomenon called reverse causation (among the other tricks I referred you to above).” You don’t actually look at studies that disagree with your views. You simply dismiss them/rationalize them away, based on your biases. You cherry-pick the research. Here is information from the Harvard T.H.Chan School of Public Health, dated July 16, 2016. This is from their Nutrition Source Update, an e-newsletter. The title is “Higher consumption of unsaturated fats linked with lower mortality”

“Consuming higher amounts of unsaturated fats was associated with lower mortality, according to a study from Harvard T.H. Chan School of Public Health. In a large study population followed for more than three decades, researchers found that higher consumption of saturated and trans fats was linked with higher mortality compared with the same number of calories from carbohydrates. Most importantly, replacing saturated fats with unsaturated fats conferred substantial health benefits.” And “…intake of HIGH (my caps) amounts of unsaturated fats—both polyunsaturated and monounsaturated—was associated with between 11% and 19% lower overall mortality compared with the same number of calories from carbohydrates. Among the polyunsaturated fats, both omega-6, found in most plant oils, and omega-3 fatty acids, found in fish and soy and canola oils, were associated with lower risk of premature death.” And, “…people who replaced saturated fats with unsaturated fats—especially polyunsaturated fats—had significantly lower risk of death overall during the study period, as well as lower risk of death from CVD, cancer, neurodegenerative disease, and respiratory disease…” On the benefits of eating fish- “Intake of marine-based omega-3 polyunsaturated fatty acids (mainly from fish) was associated with lower respiratory disease mortality and sudden cardiac death.” This result on fish is similar to a major study published in late June 2016, led by Stamford and involving over 40 researchers from 16 countries, which found that consuming fish oil results in a 10% reduced risk of fatal heart attacks, a very significant percentage.

Also from the same Harvard e-newsletter- “Findings from the Nurses’ Health Study (4) and the Health Professionals Follow-up Study (5) show that no link between the overall percentage of calories from fat and any important health outcome, including cancer, heart disease, and weight gain.” The authors reject low-fat diets, but say that most of the fat should come from polyunsaturated fats as in olive oil, fish, nuts and flax seeds.

“Rather than adopting a low-fat diet, it’s more important to focus on eating beneficial “good” fats and avoiding harmful “bad” fats.” This result contradicts the low-fat position of Dr. Greger, who also sees no value in consuming fish oil or olive oil. On olive oil, studies from the University of Crete, (Crete is part of Greece) involving 200 subjects in rural Crete with many risk factors for cardiovascular disease such as smoking, obesity and extremely high cholesterol found virtually no heart disease, similar to a result obtained in the 1950’s in the 5 Country Study. This combination of a large number of risk factors and almost non-existent heart disease correlates with the fact that Greece has the highest consumption of olive oil of any country in the world. Not proof of cause and effect, but most likely. This is also supported by the Harvard Study which followed two large groups for over 30 years. I have been using extra-virgin olive oil liberally for years and will continue to do so. I think everyone should.

Alex

The Greek letter refers the carbonyl beginning (alpha) or methyl end (omega) of a carbon chain whereas the number refers to the first double bond among carbon atoms. In the case of omega-3s we’re counting from the mythyl end and find our first double bond on the third carbon atom. Omega-6s have their first double bond on the sixth carbon atom from the methyl end of the fatty acid.

Carl Brandl-Salutz

Mercola is a crackpot, avoid him like the plague.

Cheyenne

nobody needs to consume any animal products in any form, that’s a myth. Animal products are actually bad for you. I have been vegan for 8 years and have several friends who have been vegan for over 30 years (!). The brainwashing by the meat/dairy/egg industry is profound.

Shaylen Snarski

I for one would love to be a mermaid and consume algae regularly in whole form (…. I just said that….) but since that sadly is just not the case, I think a supplement is a good idea. Though I do know other vegans who take no supplementation (but also do not eat processed foods and consume low levels of omega 6) and are doing great and their blood work comes back excellent. I eat a lot of flax and hemp, but I still feel good about getting that direct DHA most days. To me it’s a win/win since it’s sustainable and cruelty free. Though not all algae supplements are sustainable as they contain palm oil and a lot of other unhealthy filler ingredients, so I recommend taking Nutru’s OmegaZen pure DHA if you’re interested in a concentrated algae supplement or know anyone who is.
I personally think, based on everything I’ve read and learned, that it is a good idea for most people to take a long chain omega-3 supplement in the western world, but certainly not from fish oil which is just as unsustainable as it is impure. I wonder if those impurities had a large effect on the results… could the harmful toxins found in fish have canceled out the benefits from the omega-3’s?

Virginia Abreu de Paula

I ask you all to forgive me for being very ignorant in this subject and also on how to post here. The only way I managed to post was by clicking on reply to a guest. I also am not proficient in English but I do what I can. I would like to know fi somebody answered the question “How about the vegan DHA omega 3 oil supplement?” Only a few days ago my doctor prescribed me oil fish suplement. As I am vegan i decided to look for alternative. A very nice American lady suggested my the vegan DHA omega 3. I looked for where to order it and found in Amazon.com. But It seems it contains mercury. I am wrong: I hope so. It’s the Nature’s Way supplement. As my English is not perfect it’s possible I didn’t get it right. But now I discovered some people think it may be inocous. I really don’t know what to do after that. I wonder if the doctor answered. I could not find anything from him. If he answered, could you tell where? It’s very important to me because I need omega 3 and now I don’t know how to take it. I don’t want to order sucn an exoensive medication for nothing.

Thea

Virginia: I feel for you concerning your confusion and frustration. You are clearly not alone on both counts.

I am not a doctor and can not advise you on whether or not to take a DHA supplement or not. If you decide that you do want to take a vegan DHA supplement, I know that you can get them without mercury. Since I do not have personal experience with buying the DHA pills, I can’t recommend a particular brand. But for example sake, you can look at the link below to a brand I found on Amazon which contains the following ingredients (according to another website):

The caramel is disconcerting, but it seems to me that there wouldn’t be too much in a little pill. And the good news is that the brand below also includes the EPA, which as you have seen others comment on, may be just as important if not more important than the DHA.

I hope this helps.

———————————-

Example vegan DHA/EPA supplement. (One I am not endorsing.) You may be able to find it cheaper in a different brand or different site. This link would give you enough for about 3 months I believe.

not just the caramel–you don’t want the sunflower oil, nor the carragenaan, nor the sorbitol, nor the corn starch– these are all questionable additives. one of the Deva products is pure.

sher

strongly agree with you re the additives.

James

Hi Virginia,

I’ve been taking ‘Opti3’ omega 3 supplements, they seem to contain the most omega 3’s (especially DHA) of the various supplements I’ve seen. It’s completely vegan and as far as I’m aware doesn’t contain mercury.

Kim Churchman

I get an algae-derived DHA supplement at WalMart. It’s around $10 for 30 capsules. They’re big, but I can swallow them with applesauce. Try searching again, Amazon can’t be the only vendor. Hope this helps you, good for you for staying out of fish-oil. There’s a mad rush on to strip every last fish out of the ocean for it. I heard they overfished menhaden and now they are going more for hake.

Ruby

I did some study on krill oil a few years ago. Aparently it loses 50% or more of it’s freshness, once it’s gathered, even before it hits shore, and if “cracked”, way more is lost – they said 75% (I assume tested long before it got to me). I got the uncracked kind and I could tell immediately it was rancid and never took it. Omegas do not like air and light. Conversely my black walnut hull powder comes smelling delicious and aromatic and stays that way in my freezer and fridge, as does my green algae. :)

William

This whole thing started several decades ago when it was reported that Eskimos seldom died of heart disease, and that they ate plenty of cold water fish. So why did the Eskimos not suffer many heart attacks when they ate an almost totally carnivore diet? Because they died early from other diseases before they could develop heart disease. Turns out that Eskimos had the shortest life expectancy of any group in North America, often suffering from premature old age or dying from brain hemorrhage from excessive omega-3s making their blood too thin. They also got plenty of nosebleeds. Another group, the Masai in Africa, who don’t get much heart disease, are a big meat eaters and they die at the ripe old age of 43 on average, the lowest life expectancy of any people group in the world. We have no nutritional requirement for the EPA or DHA, the long preformed omega-3 fatty acids found in fish; we do however have a nutritional requirement for ALA, the omega-3 fatty acid found widely distributed in plant foods.

brec

Whenever I read about low life expectancies I’m cautious about concluding that few in the population reached elder status, because the low average may have been largely a result of high infant and child mortality.

I’m not saying that’s the case with the Inuit and Masai, because I don’t know.

Alex

I lived in Greenland for four years and studied the history of the Arctic extensively from my arm-chair. It is indeed true that the Inuit population had high infant mortality but also high mortality among those who survived childhood. The life expectancy rose significantly over the past 100 and 50 years although is still relatively low compared to global averages. After the age of five, the largest ten-year block of mortality was 35-45 followed by 45-55 followed by 25-35 year olds. After the age of five, only a quarter of the population was expected to live beyond 60. Today while on average, the Inuit live longer, the largest mortality blocks are much lower aged (teens and twenties) primarily due to shockingly high suicide and homicide rates which were almost non-existant 75 years earlier. Today in Canada the life expectancy of the Inuit are almost exactly ten years shorter than the Canadian average for both men and women.

Mike

The Masai keep their cholesterol low by consuming food high in saponins. Perhaps that’s part of the reason for low cardiovascular disease, in spite of their early demise. Just the same, we can learn from them by including saponin in our diet too. Perhaps that’s why beans are heart-smart; they contain saponins. Those Masai who have left their tribal lands to become urban dwellers, no longer raising cattle or hunting but instead eating more plant foods, are now living longer lives.

The book contains a very nice discussion of Omega 3s and vegan DHA supplements, etc. I highly recommend the book if this concerns you.

I don’t have time to re-write all the info from the book, but I will share two highlights:

“What should you do? The first step is to have ALA-rish foods in your diet. Have plenty of vegetables, fruits, and beans, and if you like, top your salad with slivered walnuts or gran flaxseed, for example.” He also explains why it is important to avoid not just animal fats (including fish oil), but to avoid vegetable oils too.

When talking about DHA supplements, he writes “… That said, omega-3 supplements have not yet provided their worth for preventing dementia.” And he goes on to explain why/quote studies.

Jeff Novick also has an *excellent* video on nuts and oils that may help you. Let me know if you need a link to that.

Hope that helps.

Paddycakes

I am a 95% vegan, and I take vitamin D and DHA. I eat plenty of nuts and veggies. Please see this link and advise:

Paddycakes: I believe that Dr. Greger addressed part of the article you pointed to in his video above.

The other part of the article, concerning Alzehimers, I can’t comment on. In order to comment on it, I would have to look at the studies they referenced and compare it to the studies that Dr. Barnard references and do some analysis. I don’t have the time or interest in doing so.

All I can say is that I trust Dr. Barnard as a source for this type of information. When he writes a book, Dr. Barnard does a lot of careful research. Dr. Barnard’s his own clinical studies (in the area of diabetes) have been clinically proven to be effective and helped so many people. So, if I was going to choose a source of information that I consider to be valid, I would go with Dr. Barnard.

I recommend reading the relevant portion of his book to get a better idea of what he does and does not recommend. My *interpretation* of Dr. Barnard’s writings is that he does not seem to think that a vegan DHA supplement would hurt, but he doesn’t think they are vital either if you are eating an oil-free whole plant food based diet.

Hope that helps.

Paddycakes

OK, thanks, but the sources, about five of them were cited in the last reply. There were done by scientist/doctors.

HemoDynamic, M.D.

This
is something I have wanted to post for a long time but haven’t had the time so here goes:

To anyone who reads this the jury is still out whether or not we really should be taking Vegan EPA and DHA supplements. But the reason this started was because of an Enzyme called Delta-6-desaturase (D6d) (see the image below out
of Michael Colgan, PhD’s book “You Can Prevent Cancer”).

This enzyme converts both the essential fatty acids Linoleic acid (LA, Omega 6) and Alpha-linolenic acid (ALA, Omega 3) to important
intermediates in fatty acid synthesis. Too much Linoleic acid in the diet uses up the D6d enzyme and now we cannot convert enough ALA to the important anti-inflammatory EPA and DHA molecules.

Furthermore, the D6d enzyme is also inhibited by dietary Saturated fats, Cholesterol, Trans-fat, Zinc Deficiency and Excess alcohol consumption which further limits the bodies ability to manufacture the
anti-inflammatory prostaglandins PGE1 and PGE3 (again see the image).

PGE1, PGE3 and DHA also inhibit the activation and production of Arachidonic acid reducing
inflammation in the body.

Add this to the bodies very poor (limited) ability to convert Alpha-linolenic acid to EPA and DHA (as Israel Navas Duran was so kind to post above. ALA to EPA conversion 0.3% and 8% and ALA to DHA is <4% and often undetectable in males, although higher in females with up to 21% for EPA and 9% for DHA) and now we can see why there
is a recommendation to take EPA and DHA. The theory (I think) being since EPA and DHA are so good at being anti-inflammatory and we don’t make a lot or get enough of them in our diet anymore we should add them back.

The one thing I have observed is that nearly every time we (as humans) try to add something back to our diet in pill form instead of from the whole food it tends to make the human body system unbalanced and tends to do more harm than good. Two exceptions seem to be Vitamin B12 and vitamin D. And really sun exposure is better than Vitamin D supplementation.

Do I take EPA and DHA supplements, no, and I
haven’t for over 3 years. Maybe I’m missing out but for now I am still alive, practicing medicine and racing mountain bikes. :)

HemoDynamic, M.D.

for whatever reason the image was taken out of the last post.

mike at the river

HemoDynamic MD, I believe in what you say on DHA, EPA and vegan supplements, but the one group I hear that can’t, or mostly, make the conversion fr ALA, even with a excellent low fat, plant based diet, with good ration Omega 6 and Omega 3; is male Diabetics, particular older male Type I Diabetics. Any ideas on this?

HemoDynamic, M.D.

You are correct inflammatory disease states (Diabetes, CAD etc) also seem to inhibit Delta 6 and Delta 5 Desaturase limiting not only DHA and EPA formation but also Arachidonic Acid formation.

Dr. HemoDynamic: That was SUCH a helpful post!! Thank you very much for taking the time to weigh in.

e

yes,both posts by HemoDynamics have excellent info–very helpful–
many thanks HD
this whole thread is good…

e

you and others speak of the body’s limited ability to elongate to DHA and EPA; this is usually said (written) in a way in which limited is taken to be a fault–but what if the body wisely has this brake because too much DHA/EPA could be damaging? Quite possibly, we need very little, and that little I would think should be made by the body as needed.

e

sorry, meant to add that it appears that would be wiser to limit omega-6 rather than add DHA/EPA…

HemoDynamic, M.D.

I agree! That is what I spoke about earlier. The omega 6/3 ratio has changed and it appears for the worst. From Old World 1:1 to New World 10-25:1. Getting back to the 1:1 ration would appear to be ideal. Watch this informative but older lecture (2002) on how and where EPA and DHA play their roles in squelching the Inflammatory Fire. http://www.youtube.com/watch?v=q7KeRwdIH04

I would echo Thea’s point. If you are concerned about Alzheimer’s I too would recommend Neal Barnard’s most recent book, Power Foods for the Brain. He does a terrific job of pulling together the science in an understandable fashion. As usual he cites the literature to support his opinions.

Paddycakes

Thank you, I will do this. You reply is appreciated.

Belette

What about the beneficial effects of Omega3 (fish oil) on the brain? True of false?

Thea

Belette: Here is a news update that I got some time ago from PCRM:

Fish Oil Supplements No Help to Heart or Brain

Two new studies found that omega-3 supplements, often sold in the form of fish oil, do not improve the health of the brain or heart.

After following more than 12,500 type 2 diabetes patients over the age of 50 for an average of 6.2 years, researchers saw no difference in heart health between those taking an omega-3 supplement versus a placebo. Diabetes patients are two to four times more likely to suffer from heart disease or a stroke, compared with people without diabetes. Another recent meta-analysis came to the same conclusion for people with a history of heart problems.

Additionally, in a new review looking at omega-3 supplementation for brain health, researchers found no link between omega-3 supplements and the prevention or improvement of dementia.

Thea, this same logic implies, to me, that we should not be taking vegan DHA supplements…that they are a waste of money (and possibly health).

Thea

wow: I don’t know. I’m not a doctor.

Here’s my thoughts: There could be aspects of fish oil (like contaminants?) which interfere with health outcomes and which are not present (in a good way) in the vegan DHA supplements. Also, as some people have pointed out, the studies done here are on people eating a SAD diet. Is there a reason to believe that vegan DHA supplements would help someone on a whole plant food based diet? I think the theory is there to believe so, but my guess is that we don’t have enough hard evidence. I’m hoping that Toxins and Darryl and others might chime in. But my bottom line so far is: We just don’t know. With that, then you have to go with what feels right to you.

Here are the types of questions I ask myself when I am faced with a decision like this that does not have as much data I would like: Is there something lacking about my personal diet for which a DHA supplement would fill in a hole? Or do I have a particular condition/health problem for which a DHA supplement would provide benefit? (And is there some evidence to back it up, even if just a carefully designed personal experiment?) While whole plant foods are better as a rule of thumb, are DHA pills one of the exceptions? Is there any evidence that it would hurt me to take DHA pills? Would I feel better emotionally if I took them? Is my budget healthy enough that taking DHA pills would not mean giving up something else that is maybe more likely to help with my health? If I took the pills, would it change my behavior to the worse, relying on those pills to make me healthy instead of just eating healthy (say flax seed)? If I bought the pills, am I going to actually (remember to) take them? If we don’t have a lot of evidence about whether or not a substance is worth eating, can I come up with a reasonable/sensible dosage to take?

Again, I hope more knowledgeable people will jump in with some hard data if it is available. But regardless of this particular issue (DHA), we are constantly faced with nutrition questions for which we do not have a solid answer. So, it is helpful to have a framework of questions to help us evaluate how to proceed.

How do other people decide how to proceed when we don’t have all the scientific data we need to be confident in our choice?

wow

Thea, well said. Your words are appreciated. This is a topic that Dr. Greger put a video out on, but I think some people on this website have raised some very important questions and concerns over the past months, as well as today, regarding taking vegan DHA supplements, and Dr. Greger has chosen so far not to comment, yet he comments on other issues of apparently far less interest amongst his viewers. This seems to be an issue that holds, arguably, the most interest, it seems, amongst his viewers. That alone, I would hope, would get him to reply to someone here about this.

Thea

wow: I hear you!

Note: I am just a volunteer on this site. I do not converse with Dr. Greger any more than anyone else. So, I can’t speak for Dr. Greger.

*My* opinion is that Dr. Greger rightly keeps a reasonable focus/scope for this site. *I* (I’m not speaking for NutritionFacts) define this scope as: NutritionFacts is reporting the relevant new science as it becomes available. As a general rule, Dr. Greger doesn’t speculate. So, if we don’t have a study specifically on vegan DHA, then he isn’t going to spend time trying to guess about it. Especially since people might take such a speculation as gospel. However, Dr. Greger has said before that he reads these comments and uses them, in part, to pick what subjects to cover when covering the new studies. So, I’m sure these questions posted here will be at the back of Dr. Greger’s mind and should relevant, well-done studies become available, Dr. Greger is likely to cover that in a future video because of the interest by people like you and me.

That said, I think Dr. Greger has already answered this question well enough. Dr. Greger has a page on this site where he lists his nutritional recommendations:http://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/
These recommendations include DHA supplements. Dr. Greger hasn’t changed his opinion on his recommendations according the postings on this site to date. (Dr. Greger did hint a bit ago that he would be updating his recommendations, so we may see a change.) This says to me that Dr. Greger feels that there is strong enough evidence to support taking a DHA supplement despite what we see about fish oil. Given how many supplements that Dr. Greger does *not* recommend, I think the inclusion of DHA on his recommendation page shows strong support for it by Dr. Greger.

I understand you wanting to get some direct answers. This reply is just my 2 cents. I hope you get the answers you are looking for.

Veganrunner

Thea am I making this up or do I remember hearing dr Greger was coming out with a revised supplement list? I would think he would following the new meta-analysis and systematic review. I may have been dreaming.

Thea

Veganrunner: I remember some hint about posting a revised set of nutrition recommendations, which would include relevant supplements. I don’t know if that plan got scratched due to no changes or if it is still in works for the near future.

Bottom line: I don’t think you are making it up. Your brain is in good working order regardless of your fat intake situation. ;-)

guest

Thea, you mention that Dr. Greger doesn’t speculate. Well, in many of his videos he actually does, as he offers his opinions based on possibilities. I do not have the time to list links in his videos for this but if you go back in the archives you will find many such comments of his where he does give hints of speculation. And this is normal. Dr. Greger’s silence on this issue is raising red-flags on the vegan DHA issue. He has a video saying don’t take vitamin E in supplemental form yet all vegan DHA has vitamin E added to it. You see the red-flag?

Thea

guest: I’m sorry, but I’m not sure what you are getting at. Red flag as in something fishy (ha ha) or underhanded???

What I do see is that we don’t have an easy answer. So, some people may quite reasonably decide to not take a vegan DHA pill based on the latest information. In that sense, I guess you could say that this study pops up a red flag about older recommendations suggesting people take DHA pills.

From my perspective: We don’t have perfect information on this topic yet. We even have some contradictory information. Even if we had a clear picture of what to do right now, we probably don’t have the access to the perfect solution (like say access to a vegan DHA supplement without vitamin E). So everyone will have to weight the various contradictory information and make your best guess. Dr. Greger may be in the process of revising his nutrition recommendations – or not. For now, his recommendation is to take a vegan DHA pill, but not extra, separate vitamin E.

If you are confused or frustrated by the situation, I don’t blame you. I just plan for myself to be extra patient on the issue. Dr. Greger has to be very careful when making his official nutrition recommendations, because lots of people listen to him. I doubt one study either way would be sufficient reason to change a recommendation. When the body of evidence becomes more clear, then I suspect we will hear from Dr. Greger. (Note: This is just my guess/my understanding of the situation. I do not have any insider information or conversations with Dr. Greger.)

Einstein

Maybe they should release a book “Oils for dummies” People who consume oil die

Einstein

Animals never worry about diet and some NEVER eat Fish Oils or vegetable oils, and look how healthy they are !!! Basically all animals that hunt, eat meat and some green foods have their eye’s to the front same as humans, our tooth structure is what they call Omniverous, we are designed to eat anything.

Fish and vegetable oils are pushed by companies that just want to sell Crap.

Lard, Dripping and butter are animal fats and far healthier and more easily absorbed by the human body, eat these and you will be healthier and happier, Just don’t overdo it with your diet, everything in moderation.

HemoDynamic, M.D.

Wow (This is a repost I left from above)

This is something I have wanted to post for a long time but haven’t had the time so here goes:

To anyone who reads this the jury is still out whether or not we really should be taking Vegan EPA and DHA supplements. But the reason this started was because of an Enzyme called Delta-6-desaturase (D6d) (see the image below out
of Michael Colgan, PhD’s book “You Can Prevent Cancer”).

This enzyme converts both the essential fatty acids Linoleic acid (LA, Omega 6) and Alpha-linolenic acid (ALA, Omega 3) to important
intermediates in fatty acid synthesis. Too much Linoleic acid in the diet uses up the D6d enzyme and now we cannot convert enough ALA to the important anti-inflammatory EPA and DHA molecules.

Also our old world (unprocessed-whole food) diet used to have an Omega 6 to Omega 3 ratio of 1:1 but now is between 10:1 and 25:1.http://www.ncbi.nlm.nih.gov/pu…
This imbalance tips the scales for processing Omega 6 rather than Omega 3 leaving us even more deficient in EPA and DHA and increasing the substrates available for formation of too much of the pro-inflammatory molecule Arachidonic acid (PGE2). A side note is we must have arachidonic acid in our bodies because without it we would die, but our bodies make all we need and we don’t need more—the more arachidonic acid we get the more inflammation we have leading to a chronic low level of inflammation (meta-inflammation) which is the underlying problem of all chronic disease.

Furthermore, the D6d enzyme is also inhibited by dietary Saturated fats, Cholesterol, Trans-fat, Zinc Deficiency and Excess alcohol consumption which further limits the bodies ability to manufacture the
anti-inflammatory prostaglandins PGE1 and PGE3 (again see the image).

PGE1, PGE3 and DHA also inhibit the activation and production of Arachidonic acid reducing
inflammation in the body.

Add this to the bodies very poor (limited) ability to convert Alpha-linolenic acid to EPA and DHA (as Israel Navas Duran was so kind to post above. ALA to EPA conversion 0.3% and 8% and ALA to DHA is <4% and often undetectable in males, although higher in females with up to 21% for EPA and 9% for DHA) and now we can see why there
is a recommendation to take EPA and DHA. The theory (I think) being since EPA and DHA are so good at being anti-inflammatory and we don’t make a lot or get enough of them in our diet anymore we should add them back.

The one thing I have observed is that nearly every time we (as humans) try to add something back to our diet in pill form instead of from the whole food it tends to make the human body system unbalanced and tends to do more harm than good. Two exceptions seem to be Vitamin B12 and vitamin D. And really sun exposure is better than Vitamin D supplementation.

Making sense of science means never putting all your eggs into one study. You have to look at the body of work. So, make of this particular study what you will.

It’s my understanding that overall we don’t have much evidence showing that adding fish oil to our diet improves brain health. All we had originally was a study of brains of older people and saw that those who had more dementia also had less omega 3s in the cells of their brains. So, that led to speculation that eating/consuming more omega 3s in the form of fish oil would be protective. Now, as I understand it, the studies which had tested that theory are showing the theory/speculation to be false.

That’s just my interpretation based on what I know, which is probably not enough.

Does that mean vegan DHA also provides no benefit? And if so, how should a vegan get the necessary DHA? Seaweed?

Thanks for all you do

Guest

It totally saddens me that they can’t just sell us some factory-grown, fresh, safe algae instead of having to extract the oil and preserve it with “vitamin E” (not good for us). I mean, just gives us the algae and leave the pill and the additives out of the product. Some of the brands are even adding vitamin A (synthetic).

Guest

What about fish oil for vitamin D and joint protection? That is another benefit they claim. I would rather get vitamin D from supplements or mushrooms.

HemoDynamic, M.D.

Or the Sun! :)

pm

It’s not surprizing that a journal that is heavily funded by the pharmaceutical industry puts out research condemning the use of omega 3 fish oil. The reason is that their sponsors can’t make any money telling people to take omega 3 supplements, while they can reap in billions selling statins instead. Jama accordingly recommends taking statins to prevent heart disease, despite admitting that possibly only 1 out a 100 prescribed may see some benefit. The rest are subject to side effects adversely affecting brain, muscle, kidney and pancreatic health.

“For every 100 patients with elevated cholesterol levels who take statins for five years, a myocardial infarction will be prevented in one or two patients,” they write. “Preventing a heart attack is a meaningful outcome. However, by taking statins, one or more patients will develop diabetes and 20% or more will experience disabling symptoms, including muscle weakness, fatigue, and memory loss.” http://www.medscape.com/viewarticle/761834
I don’t care how prestigious JAMA is, I refuse to take seriously anyone offering advice like that.

Omega 3 are vital to brain and cardiovascular health. They are a very powerful free radical scavenger and I will continue to take them daily.

Ariel Gail MacLean

what about high-Omega3 from a regular consumption of high levels of omega 3 seeds and nuts?? any benefit from that source of omega 3?

Thea

Ariel: NutritionFacts *does* have several videos showing the benefits of eating nuts and seeds.

I don’t think we know for a fact whether or not those benefits are due to a particular aspect of the nut/seed (say a type of fat) or the whole package (my vote for this one). For me, it doesn’t matter. I just enjoy the nut. I hope I’m not what I eat. ;-)

What ’bout the supposed anti-inflammatory benefits of fish oil or more specifically Omega 3? As an MS patient, I’m more concerned about inflammation (although their may be a direct–and certainly is an indirect–connection). Nonetheless, I’ve taken a lot of drugs (I’m also a cancer survivor); and I pretty in tune with what works and what does not. (Most have not). Yet, I must say that I DO feel better when I take an Omega 3 supplement. So when Dr. Greger says “doctors should stop highly marketed fish oil supplement use in ALL of our patients,” is that a suggestion there is not value in Omega 3 supplementation or just Fish Oil supplementation?

Thea

Paul: I’m sorry you have to deal with those ailments.

I can’t address whether or not a vegan DHA or fish oil can help with inflammation (because I don’t know). However, just in case you were not aware, I wanted to let you know that Dr. Greger does have some great videos on NutritionFacts which address MS.

You might also want to search the web for videos from Dr. McDougall on his research into MS. (I don’t have a link handy myself or I would share it.) He still needs to publish the latest information from the latest study, but I saw at least one video with some great info about how well MS patients do on his diet.

Thanks for the information. And for the record or anecdote, I should note that 3 years ago, I could only walk with a cane and since adopting a plant-based diet; I am now able to run (albeit painfully and slowly) 5K races at the weekends. Much of my inflammation has been reduced naturally through diet (not supplements nor medication). This was unexpected as I went Vegan to fight my stomach cancer, not my MS, but I still do swig a tablespoon of Flaxseed every morning and wondering if its worth it.

Paddycakes

Please, don’t give the FLAX, it’s healing your body. Take it the rest of your life which I hope is a long one.

Thanks Paddycakes. But curious? What’s the basis of your Flaxseed oil recommendation? I understand that while fish and flax both contain Omega 3, it’s the EPA/DHA of fish (or algae) that is (allegedly) the key beneficial component. So, do we convert the ALA from flaxseed oil; OR is there value alone in the ALA from flaxseed that is either equal or better?

Paddycakes

There are many more benefits, just google ‘benefits’ of flaxseeds.

The Benefits of Flaxseed

Is flaxseed the new wonder food? Preliminary studies show that it may help fight heart disease, diabetes and breast cancer.

Save This Article For LaterWebMD Archive

Some call it one of the most powerful plant foods on the planet. There’s some evidence it may help reduce your risk of heart disease, cancer, stroke, and diabetes. That’s quite a tall order for a tiny seed that’s been around for centuries.

Flaxseed was cultivated in Babylon as early as 3000 BC. In the 8th century, King Charlemagne believed so strongly in the health benefits of flaxseed that he passed laws requiring his subjects to consume it. Now, thirteen centuries later, some experts say we have preliminary research to back up what Charlemagne suspected.

Flaxseed is found in all kinds of today’s foods from crackers to frozen waffles to oatmeal. The Flax Council estimates close to 300 new flax-based products were launched in the U.S. and Canada in 2010 alone. Not only has consumer demand for flaxseed grown, agricultural use has also increased. Flaxseed is what’s used to feed all those chickens that are laying eggs with higher levels of omega-3 fatty acids.

Although flaxseed contains all sorts of healthy components, it owes its primary healthy reputation to three of them:

Omega-3 essential fatty acids, “good” fats that have been shown to have heart-healthy effects. Each tablespoon of ground flaxseed contains about 1.8 grams of plant omega-3s.

Lignans, which have both plant estrogen and antioxidant qualities. Flaxseed contains 75 to 800 times more lignans than other plant foods.

Fiber. Flaxseed contains both the soluble and insoluble types.

The Health Benefits of Flax

Although Lilian Thompson, PhD, an internationally known flaxseed researcher from the University of Toronto, says she wouldn’t call any of the health benefits of flax “conclusively established,” research indicates that flax may reduce risks of certain cancers as well as cardiovascular disease and lung disease.

Cancer

Recent studies have suggested that flaxseed may have a protective effect against breast cancer, prostate cancer, and colon cancer. At least two of the components in flaxseed seem to contribute, says Kelley C. Fitzpatrick, director of health and nutrition with the Flax Council of Canada.

In animal studies, the plant omega-3 fatty acid found in flaxseed, called ALA, inhibited tumor incidence and growth.

The lignans in flaxseed may provide some protection against cancers that are sensitive to hormones without interfering with the breast cancer drug tamoxifen. Thompson says some studies have suggested that exposure to lignans during adolescence helps reduce the risk of breast cancer and may also increase the survival of breast cancer patients.

Lignans may help protect against cancer by blocking enzymes that are involved in hormone metabolism and interfering with the growth and spread of tumor cells.

Some of the other components in flaxseed also have antioxidant properties, which may contribute to protection against cancer and heart disease.

Paddycakes

Years of research to help with diabetes maintenance and cancer prevention.

Thea

Paul: Thank you for sharing your story! I LOVE stories like that. I’m guessing that you may not learn much from the sources I pointed to. You already sound like a pro.

On the topic of swigging flaxseed oil, I think that Paddycakes is suggesting that you take the actual ground flaxseed instead of the oil. Dr. Greger has several great videos on the many benefits of ground flaxseed and I believe that all of those reasons would still be valid. Dr. Greger recommends about 2 Tablespoons a day. I put it in my morning oatmeal/buckwheat. Other people put it in their smoothies. If you are interested, Paddycakes listed some good info about ground flaxseed, but if you want the information in the format of this site, check out:http://nutritionfacts.org/index.php?s=flaxseed

I wish you all the best.

JoAnn Downey

I too use ground flaxseed, which is very stable, even when heated. Not so flaxseed oil which is very unstable and cannot be heated.

MBGLIFE

From the DHA algae videos here it seems that the focus is on brain and eye health. Assuming those benefits still stand for the algae and plant derived DHA, should we stop taking supplements sourced from algae given the continuous ocean contamination with radiation from the crippled Japanese reactors? Not many sources reporting it but the problem isn’t just that the radiation is now reaching the US pacific shores, it’s that the contamination is not contained and continues daily. So I wonder if I should buy another bottle of algae DHA pills when my current bottle runs out.

Thea

MBGLIFE: I can’t comment on whether or not you should take DHA pills as I think that is an open question for a lot of people.

I did want to address your concern for contamination, however. It is my understanding (perhaps incorrectly) that the companies who sell the vegan DHA pills grow the algea in carefully controlled environments. They are not harvesting from the ocean. So, I do not think you need to be concerned that the vegan DHA is contaminated.

You could check with the company you buy from to verify if this is a big concern for you.

Hope that helps.

mbglife

That does help. Thanks. I guess we just have to wait and see if there is any info on whether algae DHA supplements are helpful.

DGH

I tend to buy into a line said once by a vegan RD that “if there is a 1% risk that being completely deficient in DHA could lead to dementia, it’s a 1% risk I’m not willing to take”. In other words, there’s no harm with DHA, and it’s been studied in hundreds of thousands of patients, and if being totally deficient in DHA could lead to cognitive dysfunction in my old age, then that’s a risk I’m not willing to take. I don’t see any downside other than the cost.

mike at the river

Flaxseed and Walnuts contain useful Omega 3’s, the flaxseed having many benefits, and a helpful 4:1 omega 3 to omega 6 ratio. See “Keep it Simple, Keep it Whole” by Drs Pulde and Lederman. They mention that most of us with a heathy diet and good omega 3 to omega 6 ratio, can convert omega 3 to DHA and EPA. Except possibly Diabetics. I haven’t found the mechanism for Diabetics, esp Type 1, responsible for this. As an older male Diabetic, however, I’ll follow Dr Greger and Barnard and continue to take a Vegan, algae based EPA/DHA supplement….Mike

Alicia Townsend

Most of the providers with whom I work recommend fish oil for brain function, not for heart health. Is there also research debunking this? Thanks for all you do!

Thea

Alicia: Yes, there is at least one study showing no benefit between fish oil and brain health. See my reply above for the citation.

guest

If there is any way Dr. Greger can personally get involved on this comment page today, I think many of us would appreciate it. Today’s video really shakes up the belief that vegans should be supplementing with vegan DHA. I have spoken with several people, and we are very in doubt regarding both the need and safety of vegan DHA supplementing, in light of today’s video.

Coacervate

Fish oil does not equal 0mega-3 fatty acids. Please take a minute to think it through. Whats that Essey? Oh, “NO OIL”.

guest

I think I get it. Get your omega 3 fatty acids from foods, not supplements. Right?

Coacervate

Yes thanks! Whole plant foods. Fish oil is a refined food and it is not plant sourced.

guest

The same goes for factory-derived vegan DHA oil, right? A refined food?

Wendy

There are many ways that life expectancy are affected besides what you eat. In “the olden days” We didn’t have clean areas. Was there enough water to wash your hands and brush your teeth? Were there sewers? So it is a lot about sanitation and how much that has helped us.

JoAnn Downey

I wonder if Dr. Ornish still recommends a fish oil supplement? I’ll see if I can get an answer on Backplane.

guest

Dr, Greger,

In some presentation in the early 2000’s when you found vegetarians do not live longer than omnivores you suggested that was because of inadequate Vit B12 and omega 3 intake. While, I have benefitted in several ways going predominately vegan, it doesn’t seem that simply Vit B12 would be the sole factor separating longevity between omnivores/meateaters and vegetarians.

Roberta Peck

Dr Greger please answer this paradox from early 2000 when you reported it was inadequate B12 and poor ratio of omega 6 to 3 ratio that cost vegans on longer life expectancy. Flax does not convert easily especially as one ages. So how is a vegan to improve the omega 6 to 3 ratio? My understanding is that the fish oil provided in many of these studies was too meager to balance the outrageous omega 6 levels the SAD provides.

Thea

Roberta: re: “…how is a vegan to improve the omega 6 to 3 ratio?”

Here’s my understanding: A vegan can improve the ratio by cutting back on omega 6 rich foods while maximizing whole plant food omega 3 rich foods. This includes all of the following:

1) no oils
2) eat whole plant foods

3) limit nut *a lot* or at least stick to the right kind of walnut
4) eat lots and lots and lots and lots and lots of greens.
5) consider adding some ground flax or chia seeds to your diet.

My understanding is that if you truly did all of the above, then you would automatically have the perfect ratio of omega 6 to omega 3. Jeff Novick’s lecture, From Oil to Nuts does an **excellent** job of explaining all this, including with tables and graphs that help you see how it all works and which foods have which types of fats, etc.

Of course, many of us (myself included) fall short of such an ideal diet. I try to improve all the time, but I’m still not “there”. So, it might behoove us to consider an algea-based DHA supplement. Just a thought.

Good luck.

Roberta

Thea,
I hope the steps you gave work in the long run. Dr. Greger’s videos inspired my husband and me (both 65) to go totally plant based based on greens,beans,mushrooms,and colorful fruits and vegetables,plus recommended d and B12. However I continued with my 3 capsules of high quality Omnipure-brand fish oil, whereas my husband did not.

Next we ordered the $70. Home finger prick test from Zonediagnostics. Mine came back a desirable 2 to 1 omega 6 to omega 3ratio, my husband’s came back a mediocre 6 to 1. I talked to Dr Harris who runs the lab for Dr Barry Sears, my results revealed that 99.5 of Dr Barry Sears patients who follow his meat eating zone diet, tested at a higher level of omega 6 to omega 3 ratio.

Thea

Roberta: Congratulations on making the shift (mostly) to a plant based diet. That is a hard thing for many people to do, but it sounds like you and your husband have made great strides.

I can’t comment on the particular situation between you and your husband since there are so many factors involved. Are you both still consuming oils? How much nuts? How good is that home prick test? What might the effect of your diets have been on your bodies prior to this change? etc. There are just too many factors involved to draw any conclusions from your anecdote. (Though thank you for sharing it. I find people’s stories to be very interesting.)

As for the Zone diet, it is easy to see how someone on such a diet could have a better omega 6 to 3 ratio depending on what they are really eating and depending on who else we are comparing them to. Another factor would be, “what does ‘better’ mean”? And how scientific is this statistic? Is there a control group? etc.

Even if we want to believe that the 99.5 number actually means something, that doesn’t mean that the people on the diet are healthy or that the Zone diet is one that leads to healthy outcomes. The omega 6 to 3 ratio is just one factor/indicator.

As an example to illustrate my point: Think of the people who claim that their bad cholesterol went down when they went on the ___ diet. (Fill in the blank with any of the following: paleo, aktins, wheat belly, eat for your blood type, etc) However, what we all know is that people can loose weight on just about any diet. At least when people start a diet, most people tend to loose weight, initially. And when you loose weight, your bad cholesterol goes down. But bad cholesterol is just one factor of health. And we have a TON of evidence that those high-meat/high-fat/low complex carb diets are extremely bad for people’s overall health.

Those are just some thoughts for you on how you might think about the Zone data.

One other thought is: If you think that the fish oil is helpful for you, you might consider following Dr. Greger’s recommendation to take a plant-based DHA supplement instead. That would give you several advantages: knowing you aren’t getting toxins that are often found in fish oils, skipping the middle man and getting the DHA directly (the point of omega 3 fats is so that your body can convert them to DHA), and not contributing to the collapse of the oceans. Just a thought.

I hope you and your husband experience great health going forward.

Seri

thanks for the understandable suggestions Thea. :-)

Don

Thanks for this video I just
received from a friend of mine I’m
left wondering, since it is stated in prior studies if omega 3 still
benefits for those suffering from an inflammatory process, (i.e. not heart and or
cardiovascular related).

Steveonline

I recall from way back when, a Nutritionfacts piece about how population death rates among vegans was no better than the general population and that was attributed to deficiencies of dietary omega 3 fatty acids and vitamin B-12 among many vegans and vegetarians. I hope you follow-up today’s piece with useful guidance for maintaining adequate omega 3 status, perhaps flax as many commenters have speculated.

vardarac

To my knowledge, flax contains omega-3 mostly in the form of ALA, which does not readily convert to DHA or EPA. Maybe Atlantic seaweed or algae would be a better approach?

“Overall, our results supply evidence that long-term effect of high dose omega-3 fatty acid supplementation may be beneficial for the onset of cardiac death, sudden death and myocardial infarction among patients with a history of cardiovascular disease.”

As for this video – it is sooo misleading as it is talking only on the benefit to the heart while the true benefit is for the brain… It is well known that there’s no evidence for the benefit of omega-3 to the heart – it’s not a big discovery here. But this video sounds like wow – ‘throw your omega 3 supplements out the window guys’ which is so untrue!

The recommendation at the end of this video is misleading as well – the cardio vascular doctors are talking about not recommending these supplements to THEIR patients. THEIR patients are having a heart disease. All they care about is THEIR patients heart problems. But some of the same patients and other patients are slowly dying from Dementia, Alzheimer’s and cognition problems because they are not taking the pills….

So make sure you supplement today with your favorite DHA supplement.

Aviel.

EP_2012

The video was reporting on the alleged benefits of fish oil for reducing heart, stroke and mortality rates, which it doesn’t.

It had nothing to do with brain function and Dr. Greger still recommends DHA, which is different from just “omega-3 supplements”, and he does so for brain health (not heart, stroke or lower mortality).

Coacervate

OK, I will say it again. Fish oil is not the SAME

Gary Scearce

It seems that the studies that purportedly discredit the benefit of fish oil were horribly designed “recollection” interrogations and not valid double blind placebo controlled studies. There were other studies that used ridiculously low levels of Omega 3’s and trumpeted that there were no improvements in heart health. Even with small doses of DHA/EPA, there were statistical improvements in mortality. The truth is that science can be bought and there are powerful forces that want to discredit anything that is not patented by a pharmaceutical company.
Gary Scearce, OD

EP_2012

“It seems that the studies that purportedly discredit the benefit of fish oil were horribly designed “recollection” interrogations and not valid double blind placebo controlled studies.”

I take it you didn’t look at the studies?

“14 randomized, double-blind, placebo-controlled trials (involving 20 485 patients with a history of CVD) were included in the final analyses”

Evan

So does this negate all the benefits of flax in ones diet with regarding the heart ?

HemoDynamic, M.D.

Great Update! One thing I have noted in my new multi-physician practice is that it is hard to break learned habits. I have been giving the research and information to the providers in my practice for over six months (in a gentle, informative and positive way) and they are having a difficult time changing their fish-oil prescribing practice. Even after showing them it is now a grade A recommendation to STOP prescribing Omega 3 for cardiovascular protection, (The Journal of Family Practice August 2013) I still get patients that have recently been put on Omega 3’s for primary, secondary and tertiary cardiac protection.

Bottom line keep up these pertinent updates to make sure the most recent information continues to be disseminated among the general population; for many patients are, and continue to be, the driving force for change in the medical world.

Anabel

Hi Dr. Gregor,

The video about fish oil is interesting My cardiology colleagues have adopted that info very quickly. I wish they could be so quick to recommend a vegan diet. They are stopping fish oil.
But we are forgetting about the research of omega 3 fats as an extremely important nutritional element in brain science.
Could you please comment on omega 3 and brain health as a follow up of the current video.
The paleo-dietitian friend I mentioned a while ago claims she recommends her patients omega 3 from 4 manufactures that have a special purification system that takes all DDT and mercury out.

nfk

many baby formulars contain DHA so I guess it is proven helpfull ingredients as baby milk powder safety and effieciency is not something that big pharma like JNJ abbort would lightly handle

Marie

You are absolutely, totally wrong, Doctor! The so-called “evidence” you quote from is flawed. There is always some body or laboratory or other trying to denigrate the supplement companies. My deep-sea lipid source arose from 35 years of research into fish oils, and has been proved to work by millions of people over the last 34 years! (The 35 years of research happened before the 34 years that I quote here). Please contact me for the research from which I take my advice.

Fish oil can go “rancid” very quickly and easily unless it is sheltered from oxygen, light, and heat. And it will one day be unsustainable. Krill oil should be researched more so than fish oil because that will be the future of American omega 3 consumption (in animal derived omega 3). Krill is supposedly very resilient to oxygenation and heat/UV damage because of its high level of astaxanthin. Check out Mercola’s article @ http://articles.mercola.com/sites/articles/archive/2014/02/09/fish-oil-brain-health.aspx

Dang! I guess Krill is a type of shellfish so people who are allergic to shellfish-which I know there are a lot-do not take krill supplements!
Minus 1 point for krill oil
Back to 1 point for Rob.

Mike

What about this recent publication about omega-3’s role in brain wiring?
It was conducted in rhesus macaque, but does this mean that we should ignore any possible implications for humans? Certainly we need omega-3’s in our diet. However, omega-3 in the form of supplementation or prescribed for treatment for disease, maybe not.http://www.jneurosci.org/content/34/6/2065.short

Dr. Greger has a long video on why vegans die before they should. The 2 main reasons was lack of vitamin B-12 and too low a ratio of omega-3 to omega-6. Vegetable oils (not including olive oil that is high in omega-9) is high in omega-6. The reason for consuming fish oil is the high amounts of omega-3 in them.
Also there are too many studies that are done wrong based on false assumptions. Before Albert Einstein there was a major contradiction in physics so all they could do was ignore it. It was based on the false assumption that time always moves at the same rate (it cannot speed up or slow down). Also they assumed that lengths could not contract.

Dr Paul Stevens

ALL of our patients?? Not all of my patients have CVD risk, but many have autoimmune/inflammatory disease. What about the benefits for chronic inflammatory diseases, Rheumatoid, Lupus, major depression??

larry johnston

This doctor is as uninformed as Dr Marcola. Give me a break. Ever wonder why heart disease is the number one killer in the US? It is because of bad information like this so called doctor. The medical community has lowered the cholesterol number to low. The reason they did that was so they could sell cholesterol medication. Now it is to low. We need healthy number of the good cholesterol, but not the bad LDL. Our bodies need the oils for many reasons like cleaning out bad LDL, and for our brain membranes . just to name only two. He puts a dollar figure on what he claims unnecessary fish oil sales, yet you can bet your “you know what” he’s getting huge kick backs on pushing real unnecessary pharmaceutical drugs instead of telling his patients to eat a healthy diet, exercise or take good whole food supplements. Typical doctor with a small d in front of his name. Jesus fed the five thousand ( FISH ) and ( BREAD ). WHY? Because of the OILS He created for our bodies and the LIPEDS and STEROLS that were in bread then which are not now because they have been removed so bread last longer on the store shelves. Do the research.

Tommasina

Hi Larry, Please no ad hominem attacks–we try to keep this a safe place for everyone. Dr. Greger reads through thousands of peer-reviewed research articles a year to create these videos for NutritionFacts.org, a registered nonprofit.

I’ve heard anectdotal info that an ADD kid on fish oil 3 days showed a whole different balanced personality, immediately. Heart issues notwithstanding, I wonder about brain and nerve health from this story, though I opt for plant based sources en mass, for my own body.

SecularAnimist

Hemp oil?

roberta

Dr. Barry Sears, (whose Zone diet errors in considering plant protein nonbioavailable, except for soy) is the biggest source of the importance of fish oil,
My husband and I left thThe Zone to become 100 % plantbased. I continued to take the high potency 3 capsuels of molecularly distilled fish oil Dr Sears has made convincing arguments for. My husband stopped the fish oil.
When we took the pin prick Omega 6 tp 3 ratio home test purchased from Zone Diagnostics my ratio was an ideal 2 to 1, my husband’s 6 to 1. A swollen- ointed friend I bought a test kit for had a ratio of 39 to 1,yes a whopping 39 to 1 in a 40some normal wieght woman eating the SAD.
Dr Sears response to the recent test Dr Greger noted is that the average Americans being so high on the Omega 6 side of ratio that it is no wonder the small fish oil dose given in this study proved ineffective.

Roberta Peck

John, Not only I, but Dr. Barry Sears agrees with your assumption that average Americans are so inflamed by high omega 6 to omega 3 fats that it is no wonder fish oil had no effect in this study. It would be like pouring cups of water on a raging fire then concluding that water is not effective in putting out fire.

Also, most fish oil is the “the sewer of the sea” and often rancid to boot, as Dr. Barry Sears claims. Even Dr Furhman in good character stated that his customers were originally receiving rancid fish oil,

Jeff

Flax converts what??

Shaylen Snarski

Flax contains short chain omega-3’s (ALA) which is naturally converted to DHA and EPA. Flax is the best source of omega 3’s. Hemp oil contains the perfect ratio of omega-3 to 6 and also contains SDA which helps in the conversion process. Whole flax (ground flax, you have to grind it whether you buy it ground or do it yourself with a coffee grinder at home, so you can digest it) is amazing, but the extracted oil is highly unstable and goes rancid quickly.
You can take concentrated algae supplements for direct DHA (which your body can create EPA from) as well. I recommend Nutru Omega Zen pure DHA supplements as they’re the purest and most other algae supplements contain harmful (as well as unsustainable, e.g. palm oil, which is also unhealthy) filler ingredients.
The only reason fish (and only SOME fish at that) contain DHA is because they consume algae. So when you’re taking fish oil or consuming fish, you’re getting the DHA in a 2nd hand nutrient form, plus extremely dangerous levels of toxins. Even fish oil claiming to be pure of mercury still contains mercury in some amounts, among other things. And on top of all of that, you’re contributing to the death of the oceans and planet as this is such an unsustainable practice and the oceans are already dangerously depleted.

Roberta Peck

John, Great observation about the omega 6 to 3 ratio in these patients being missing from this flawed study. The sick people in this JAMA study,on a cocktail of drugs, were probably so inflamed with processed omega 6 fats that the very meager amount of fish oil would hardly balance them back to a healthy ratio.

Also, of what quality was this meager amount of fish oil they received? Did they ingest the “sewer of the sea “type, or the ignorantly unrefrigerated and rancid type? Even Dr Furhman had the good character to report that his customers were receiving rancid oil before he used refrigeration in transport.

High potency molecularly distilled fish oil with a very small amount of vit E as a preservative are a result of resent processing ,after initial dates provided in this study, so I am assuming theses patients got very meager amounts of the standard swill of the sea.

Fish oil fan

I think the problem with the meta-analyses on fish oil supplementation, which concluded omega 3 fish oil wasn’t effective, used a placebo size dose of fish oil or fish oil of inferior quality. Just like with a drug, if you don’t take enough of a medication, it won’t do you any good. It is too bad that these studies did not use an effective dose of highly purified fish oil, because it could cause people to avoid something that could really help them. Almost all fish contains PCB’s and other contaminants. The advantage of highly refined fish oil is that it is pure – the toxins have been removed. The quality of fish oil varies among brands. I have been using it for years and when I upped the dose, the improvement in my physical and mental health was amazing.

Mindaugas Raulinaitis

Fish Oil Prevents Brain Shrinkage in Eight-Year Study

Can an abundance of fish oils in the diet keep your brain from shrinking?

A new study published in the January 2014 issue of Neurology says yes.

According to a recent column in the Science Times of the New York Times, consumption of fish but not fish oil was related to greater volume of gray matter in seniors. However, there seemed to be no benefit of consuming more than 1 serving of fish per week.http://well.blogs.nytimes.com/2014/08/20/fish-as-brain-food/

Jo Ann

These analyses do not consider either the quantity nor the quality of the supplementation. That capsules were used instead of liquid tested by FDA laboratories for potency, freshness, and minimal contaminants. (One refrigerates the oil after opening.). Also, did participants take Vitamin E along with the fish oil to deal with oxidation. I would test the validity of these analyses without an examination of the products used.

Eric Woods

I think that the evidence is still out, largely because there are such wide disparities of supplement quality, chain of custody, etc. Since I am male, I eat two ounces of canned wild Pacific salmon, a teaspoon of cod liver oil, and two tablespoons of ground flaxseed every morning. The cod liver oil is refrigerated in transit and in my own house, and has been independently evaluated by the two best independent labs in the supplement industry. My omega-6 consumption is generally less than 16g / day. Even then, it’s extremely hard to keep n-6:n-3 PUFA ratio less at 3:1, much less 2:1.

Daniel

I love how the admins post just the studies that support their beliefs. For example, kefir has so much benefits, the same with sardines and other small cold water fish. But zero talk about those here.

Ornish’s website https://www.ornish.com/proven-program/nutrition/
HIs video at 2:25, Ornish says: “3-4mgs daily of Fish Oil reduce the possibility of dying from a heart attack up to 80%”
Is he missing the research Dr.Greger talked about or is he potentially quoting something else??

It appears that Dr Ornish does suggest taking microalgae oil over fish oil for those who are concerned about it’s harmful effects (see here).

Hope this answer helps.

Rex

Thank you for replying. Being a layperson, Maybe I’m confused. I thought Dr. Greger is saying there is no benefit to taking omega-3 supplements. Not just for health concerns of toxins, as you referenced Ornish’s suggestion to take microalgae oil, but that there is NO benefit to take them period, in reducing cardiac events.

That same Ornish page you linked me to above says: “On the flip side, in 2012, JAMA published a meta-analysis that questioned the association of Omega-3 to heart health. The latest news, however, from a March, 2015 review in AHA’s journal Circulation, has re-evaluated the evidence studying the relationship between blood levels of Omega-3 fatty acids and CVD risk. It emphasizes that the significance may not be in the consumption of Omega-3, but in how well the body absorbs it. It differs in individuals based on a variety of factors such as blood level response to Omega-3 supplementation, the quality of the Omega-3 supplements, different doses and the length of supplementation as treatment.”

Has Dr. Greger taken this “re-evaluation” into account? There are older posts, prior to these 2012 & 2015 studies, still active on Dr. Greger’s site that state we should use microalgae oil for Omega 3.

I am confusing the two?

Thank you!

Blaice

Maybe I can provide some insight. I will attempt to do so at least. Dr. Gregor uploaded a video a few weeks ago or so that emphasized that DHA can inhibit brain shrinkage to a degree, but gives no claims for cardiovascular benefit. However, if you are to take fish oil instead of algae, then you brain is subject to PCBs, dioxins, and heavy metals, just as much as it is the DHA/EPA. Now, would that counteract the benefit? I would assume almost certainly. You can avoid the contamination by consuming algae.

You are not confusing, the relation between omega-3 and CVD risk is indeed quite confusing due to contradictory data.

However, Dr Greger’s position is quite clear on the matter. I highly recommend you to watch a very recent video did on the subject and why he recommends its intake (see here and here).

Hope this answer helps.

Shaylen Snarski

The only benefit of kefir is the probiotics, which you can get in purer form, without the harmful effects, from water kefir. I don’t know much about kefir itself (more of a kombucha person), but I do know the harmful effects of dairy consumption. As for fish, they contain a plethora of highly dangerous contaminants. Plus, sardines are endangered and the oceans are dangerously depleted in general and yet little to nothing is being done about it. Any benefit you can get from sardines, you can get from plant foods, and as for the pure DHA, you can get that from concentrated algae which is how those sardines have it in them in the first place.
Also, and finally, when the oceans are dead, what will future generations do? I think the best nutrition is what is best for everyone, and the purest.

Marice

Where will I get omega 3 if i don’t eat fish or take fish oil? I do eat about 1 TB of flax seed a day. I s that enough. My fish oil is from wild salmon.

Rami_RD2B

If you eat a tablespoon or 2 of ground flaxseed and your diet is generally lower in fat, then you will have sufficient omega 3. Dr. Greger recommends Algae derived omega 3 if you really wish to supplement it, although it likely is not necessary.

Alex

Surprising findings. I’m having trouble reconciling this with much else posted on this site about omega-3s. I understand the studies cited all used fish and fish oils rather than vegan sources, but nothing here suggests any vegan advantage (although one might suspect other fats, animal proteins, and toxins could be reduced or eliminated). Is there any study linking flax or ALA to heart benefits? EPA and DHA? Why is flax a worthy food: fiber, anti-inflamation, …?

Dr. Al

In review of the selected research papers did the authors state the quality and dosage? As quality highly varies from different manufacturers. Dosage also plays a role. It’s all to easy to build a study or studies with a predetermined outcome.

alexih

I am vegan, and recently very excited that my mother became vegan. HOWEVER… she has suffered from dry eyes and perhaps the onset of arthritis. Her doctor told her to take a specific brand of fish oil at a higher dose than typically taken. Amazingly, she had relief from her dry eyes and aches the next day and ever since. So… why? Could she switch to flax and have the same results? I wouldn’t want to have her switch to flax if she is going to have the problems she had before.

Charlie Ross

“Pesco-vegetarians in the community, who ate a plant-based diet with up to one serving of fish a day, lived longer than vegan Adventists.” This sentence has circulated on the internet recently. Is this true? If so…how might we account for why eating fish is better than strict vegan? Could it be that the vegan Adventists are more junk food vegans as to more whole food plant based? Or maybe the Adventists are not taking their Vit B12 or Omega 3’s? Curious as to your thoughts…..

Tom Goff

That is true. Overall, “pesco- vegetarians” had lower mortality than “vegans”.
However, if you disarticulate the figures (table 4), among males “vegans” actually had the lowest mortality not “pesco-vgetarians”.
Women were different and “pesco-vegetarians” had the lowest mortality. Even “lacto-ovo” and “semi-vegetarian” women had lower mortality than “vegan” women. I suspect this may have something to do with changed hormonal requirements in post-menopausal women but that is a pure guess on my part and there may be some sex-related confounders that affected the results.http://archinte.jamanetwork.com/article.aspx?articleid=1710093

Do you believe in the “no oil” plant-based diets? Or is some fat okay? Trying not to eat any oil, or even nuts or avocado, has been nearly impossible for us. We eat limited but some oil & fats. Do you think very low fat (and non-saturated) is okay, for an otherwise healthy person? Or do you agree with those eating plans?

Thea

Tina: Before I can answer you, your first two questions make me think need to come to agreement on terms. I try to use the terms this way:
>>> “fat” = one of the three macronutrients (fat, protein, carbohydrates) which can be found in whole plant foods (broccoli, beans, etc) or as an oil.
>>> “oil” = a heavily processed product that is pretty much nothing but fat (ex: olive oil, coconut oil, etc). oil is what you get when you take a whole food and remove everything but the fat.

If we can agree on those terms, then the question, “Is some fat okay?” is easy to answer. No one advocates a fat-free diet. There are two types of fat that are essential to have in the diet. But getting enough essential fat is easy to get in whole plant foods. Even broccoli is something like 8% fat I believe. If you include a few nuts and seeds, you can increase the amount of fat in your diet significantly. The hard part is to keep yourself from getting too much fat, which is why you often hear of a healthy diet being described as “low fat….”

Nuts and seeds are whole plant foods that have lots of fat in them. Dr. Greger has a bunch! of videos showing that nuts and seeds are health-promoting foods. (Especially check out videos on flax). But I seem to recall that Dr. Greger recommends about the same amount of nuts/seeds that other respected nutrition experts recommends, about 1 to 2 ounces a day. So, not a large part of a diet. But definitely part of a healthy diet.

So, are oils really out?!? Say it isn’t so! Here is how I put this into perspective. Jeff Novick has a GREAT talk called “From Oil to Nuts”. (I highly recommend it.) Part of that video is available free on youtube. The following clip compares olive oil to sugar.https://www.youtube.com/watch?v=lbALgjmZUek

Sugar = junk food = empty calories. and Oil = junk food = even more empty calories (since oil is twice as calorie dense as sugar). This comparison really helped me. While I understand that it is best to avoid sugar, that doesn’t mean that I never eat sugar. I just try to limit sugar as best I can. A person who occasionally eats some sugary treats or a sauce with sugar in it is probably going to be fine. I just don’t kid myself that sugar is healthy. That’s my personal decision. I take the same approach for oils. I don’t think a *tiny* amount of oil would really hurt me in the context of a truly healthy whole plant food based diet. Personally, I try to limit oils to desserts since it is so easy to get rid of oil from main dishes.

Two new studies found that omega-3 supplements, often sold in the form of fish oil, do not improve the health of the brain or heart.

After following more than 12,500 type 2 diabetes patients over the age of 50 for an average of 6.2 years, researchers saw no difference in heart health between those taking an omega-3 supplement versus a placebo. Diabetes patients are two to four times more likely to suffer from heart disease or a stroke, compared with people without diabetes. Another recent meta-analysis came to the same conclusion for people with a history of heart problems.

Additionally, in a new review looking at omega-3 supplementation for brain health, researchers found no link between omega-3 supplements and the prevention or improvement of dementia.

Hello Dr. Greger, I appreciate your web site and your videos. My personal experience trying an elimination diet in 2015 (I eliminated all dairy for 3 months and then added back in items one by one) yielded amazing results regarding dairy. I felt I wasn’t breathing as well when I started consuming cottage cheese and yogurt but that was about it. Yet, when I ate a big piece of hard cheddar cheese one night, I completely broke out in cystic acne the next morning. It was worse than I ever remember in my life, and it took my face 3 weeks to ‘calm down.’ Then, after not drinking milk for over a year, I drank a pint on 12/24/15. Literally, within minutes, I started feeling flu-like symptoms. My back (!) started hurting. My throat started to feel sore. I immediately stopped all dairy – including cottage cheese and yogurt – but it still took me about 1 month to get my breathing back to normal. My airways were clogged in a scary way.

In July 2015, I started a pescetarian diet, with limited (now no) dairy. Since then, I’ve lost 25-30 pounds and kept it of, even though I’d been exercising before by swimming, biking or running. In May 2015, I went off caffeine and sodas, cold turkey and went through a hellacious 3-day detox. I lost 10 pounds fairly quickly in about a month by just drinking mostly water. Then, in July, I went on a vegan + egg + fish diet (with minimal fish – fins and scales – and eggs).

All my life, I have exercised, and I was a college athlete, but in Fall 2014, I wasn’t feeling the energy I wanted to feel to continue strenuous work-outs. So, in October 2014, I started juicing carrots, celery and cucumbers every day. Within a week a big 3-year old wart fell off my thumb, and within 3 months, it completely disappeared (and hasn’t returned).

In any case, your post is about fish oil, and I started taking fish oil in January 2015 because my LDL was about 109. My triglycerides have always been between 55-65 and my HDL is good, but I was perplexed at my continual LDL of 107-110. So, I started taking fish, in addition to my daily juicing (no other diet changes yet). I immediately started thinking more clearly. I was amazed. And my LDL went down 20 points in about 3 months (I get regular checkups for other issues, so they check my lipids, too).

So, while I realize that mercury may be a problem in some fish, my personal experience using fish oil was very noticeable (thinking, LDL) and very positive. I eat fish abotu 2-4 times a week, and mainly eat sardines, herring and salmon. I plan to continue to do this.

As far as mercury, I just removed another amalgam tooth filling the other day, and I am very glad. I only have one more to replace with composite.

So, I really do use science and try to read up about diet, which is why I made the switch to pescetarian (without dairy and limited eggs and fish), but I feel – for now after trying with and without – that limited eggs and fish have a net positive benefit for me. So, I hope you consider my experience and perhaps encourage more studies. [I have taken 3 classes – including 2 at the graduate level – in statistics, so I understand all the “p” values and confidence intervals and everything else all those journals present without any problems. I sat next to math PhD students and did better than they in our classes, even though they had already taught basis statistics. I say this just to inform that I am a fairly informed reader…or try to be.]

Thanks again. I apologize for the longish post.

Robert Stanley

Ask yourself one question, would you eat rotten fish? If your answer to this is no, then do not take fish oil capsules. Get your good fatty acids from plant sources like Evening Primrose, or freshly ground flax.

Shaylen Snarski

100,000 tons of fish oil every year…. how terrifying this is to think of our poor oceans and all life in it, including these poor fish! All when we can be taking concentrated algae supplements instead! Which is how fish get their DHA in the first place! Not to mention the extremely dangerous contaminants found in fish. But for sustainability alone…. I don’t understand for the life of me how people can be so content in destroying our plant so vastly by the second…

Shaylen Snarski

After watching this video, I’m very confused because in one of your lectures that I just got through watching, you explain how low levels of omega 3’s in comparison to omega 6 is detrimental to overall health and why therefore, we should be consuming flax everyday. Can you please explain the contradiction here?

Tom Goff

I do not think that there is a contradiction.
Dr G’s advice here is to not consume fish oil. This has been shown to be ineffective and even harmful.
However, that is not to say we should not eat foods high in omega 3s like flax seeds, chia seeds, walnuts etc.

Shaylen Snarski

I agree fish oil is very harmful, unnecessary, and so unsustainable that it’s grotesque that it’s even allowed to be made (not even going to mention the cruelty), my confusion is that he’s saying studies show that no cardiac benefits were found with omega-3 intake, while he’s talking about fish oil, he’s not specifying that it’s only omega-3’s from fish oil that show no cardiac benefits.
And in one of his lectures he explains how beneficial to health studies have shown the Mediterranean diet to be when compared to the American Heart Association diet (if I’m getting that right) and their (the Mediterranean) diet consisted of a lot of vegetables, legumes, (olive oil which is low in omega-6), no or little dairy, and no or little meat except for fish. Of course I’m not promoting eating fish, just roughly explaining. Of course someone could follow a Mediterranean diet and get all the direct DHA without the harmful effects by taking an algae supplement (though I have to mention that people need to avoid taking ones with unhealthy and unethical fillers like palm oil).
It just sounds like he’s saying that omega-3’s have no heart health benefits which contradicts lots of other information he provided that I came across. I’d also like to know why the risks became higher when consuming fish oil… I imagine it’s all the harmful contaminants, but I’d be really interested in more on this by him.

Tom Goff

My understanding is that he is saying that studies show only that omega 3 fish oil supplements provide no benefit. Not that omega 3s in food provide no benefit. Also, in the Mediterranean Diet I believe the Cretans consumed lots of purslane which is high in omega 3.
It is probably worth doing a search in the box above for videos and articles on “fish” which will probably make things a lot clearer than I can.

Shaylen Snarski

I wonder if it’s all the contaminants in fish oil that undermine the potential positive effects of the omega-3’s… or maybe DHA doesn’t help with heart at all and only ALA does that…

Taking isolated, concentrated extracts of anything has to be considered a calculated risk. Personally, I take a good food-based vegetarian multivitamin, B12, vegetarian DHA (and Lysine therapeutically for cold sores). I have also resumed taking supplemental vitamin C after giving it up for a couple of months and then going down with the flu. I never get the flu when I supplement with vit C. But I do not think that what I am doing re supplements is absolutely certain to offer a net health advantage – just that my understanding of the science (and personal experience) suggests that it will. However, I accept that what I am doing is in effect a gamble.

deepcleavage

A comprehensive study was published today from Stanford and Tufts involving 49 researchers from 16 different countries. It examined 9 previous studies involving 45,000 individuals. The finding was that blood levels of fish and plant omega 3’s were associated with a 10% reduction in fatal heart attacks, but no reduction in non-fatal heart attacks. The authors concluded that fish was an important part of diet. The summary of the study I read, see link, did not indicate the blood levels of omega 3’s. http://medicalxpress.com/news/2016-06-consumption-omega-3s-linked-fatal-heart.html